Study shows link between low cholesterol, sex drive

A study that a professor of medicine in the Rutgers Robert Wood Johnson Medical School conducted has linked medication that lowers cholesterol with improving erectile dysfunction.

John Kostis, director of the Cardiovascular Institute at Rutgers Robert Wood Johnson Medical School, performed the study. He said it was a meta-analysis of 11 randomized controlled research studies where half of the participants took statins, a drug meant to lower cholesterol, and half took a placebo or no medication at all.

According to the American College of Cardiology’s release, erectile dysfunction affects an estimated 18 million to 30 million men and is most often seen in men over the age of 40.

Statins lower cholesterol by decreasing the liver synthesis of cholesterol, said Dr. Hossein Sadeghi-Nejad, a professor of surgery/urology at the University of Medicine and Dentistry of New Jersey-New Jersey Medical School.

The men were tasked with filling out a form to describe their perceptions of their erections, Kostis said.

Using the most advanced meta-analysis techniques, the study found that patients improved their self-perception of erectile function by 3.4 points.

Kostis said at least in the short term, the effects of statins are akin to that of testosterone, which is also prescribed to men with erectile dysfunction. 

Kostis, who has been working with statins since before the first one was marketed in the 1980s, was interested in doing this research because statins have proven to actually have opposing effects on erections. 

There are studies showing that statins cause a decrease in testosterone because testosterone is a byproduct of cholesterol, so if cholesterol is decreased, testosterone is as well, he said.

Kostis’ study lasted about six months and included approximately 700 participants. The short duration of the study and the small amount of participants are reasons that Kostis said more research is needed.

“Number one, the first thing that’s needed is a longer duration study with placebo controls, double blind, and then go for a year or two and see if the effect persists at least for a year,” he said.

Studies like these may improve knowledge about statin therapy, which is already used to avoid adverse events like sudden death, heart attack or stroke.

Kostis had to amend the study three times before it was published, heeding to recommendations from editors. The study is now on the web in the Journal of Sexual Medicine. 

Sadeghi-Nejad, also the chief of urology at the New Jersey Veterans Affairs Hospitals, said erectile dysfunction had been attributed to excess stress or being nervous.

“The whole body of research that became available in the last 20 or 30 years shifted the focus from psychogenic ED, which is still very important, to also include what we refer to as organic erectile dysfunction or non psychogenic erectile dysfunction,” he said.

A very similar study was done in the past couple of years that focused more on the effect of statins when combined with medications like Viagra and Cialis.

That study ended with the same conclusion about the role of statins in erectile dysfunction that Kostis’ did.

Sadeghi-Nejad said an important implication of Kostis’ study is that it focuses on the important role of various modulators, such as statins, as risk factors and their effects on erectile dysfunction.

“All in all, when you look at the vast majority of the studies, the effect of statins on their own or in combination with Viagra, appears to be beneficial for erectile function,” he said.

He said multiple studies have concluded that statin use improves erectile function, but it can also reduce testosterone, which can have a negative effect on erectile function.

Sadeghi-Nejad envisions that going forward physicians will be looking at more than just one standard therapy, but instead a multi-faceted, or multi-medication, approach.

In a Robert Wood Johnson press release about Kostis’ study, he said ultimately, a healthy lifestyle is the best method to prevent erectile dysfunction.

“But statin therapy has been proven to provide long-term benefits in reducing cardiovascular disease and the detrimental consequences associated with it,” he said in the press release. “Offering statin therapy to improve erectile function may extend these benefits further.”